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Ultrasound Physics--Chapter 21 & 22
Image Characteristics & Artifacts/Quality Assurance & Clinical Environment
49
Physics
Professional
04/02/2021

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Term
Portions of an image that are brighter than surrounding tissues, or tissues that appear brighter than normal.
Definition
Hyperechoic
Term
Portions of an image that are not as bright as surround tissues, or tissues that appear less bright than normal.
Definition
Hypoechoic
Term
Without echoes; echo-free
Definition
Anechoic
Term
Describes structures with equal echo brightness.
Definition
Isoechoic
Term
A portion of tissue or a structure that has similar echo characteristics throughout.
Definition
Homogeneous
Term
Displaying a variety of different echo characteristic within the tissue.
Definition
Heterogeneous
Term
What are Ultrasound artifacts?
Definition
errors in imaging
Term

What are some errors imaging?

Definition
  • Not real
  • Missing reflectors
  • Improper brightness
  • Improper shape
  • Improper size
  • Improper position
Term
What are causes of artifact?
Definition
  • Violation of assumptions (acoustic artifacts) 

 
 
  • Equipment malfunctions or design 

  • Physics of ultrasound 

  • Interpreter error (anatomic pitfalls) 

  • Operator error

Term
What are the 6 assumptions of imaging systems?
Definition
  1. Sound travels in a straight line. 

  1. Sound travels directly to a reflector and back. 

  1. Sound travels in soft tissue at exactly 1540 m/s. 

  1. Reflections arise only from structures positioned in the beam’s main axis, 

  1. The imaging plane is very thin. 

  1. The strength of a reflection is related to the characteristics of the tissue creating the reflection

Term
Multiple, equally spaced echoes caused by the bouncing of the sound wave between two strong reflectors positioned parallel to the ultrasound beam. Violation of assumption 2.
Definition
Reverberation
Term
Solid hyperechoic line directed downward. AKA ring down artifact. Violation of assumption 2. 
Definition
Comet tail
Term
 Hypoechoic or anechoic region extending downward from a highly attenuating structure. Violation of assumption 6.
Definition
Shadow
Term
Hypoechoic region extending down from the edge of a curved reflector. Caused by a decrease in intensity. Violation of assumption 6.
Definition
Edge shadow
Term
Hyperechoic region beneath tissues with abnormally low attenuation. Violation of assumption 6.
Definition
Enhancement
Term
Side-to-side region of an image appears brighter than tissues at other depths. AKA focal banding. (Appears as if a TGC is set improperly). Violation of assumption 6.
Definition
Focal enhancement
Term
Created when sound reflects off a strong reflector and is redirected toward a second structure. The artifact is located deeper than the real structure. The mirror is always located along a straight line between the transducer and the artifact. Violation of assumption 1 and 2.
Definition
Mirror image
Term
Mirror image artifact that appears on a spectral Doppler display.
Definition
Crosstalk
Term
Created when a sound wave propagates through a medium at a speed other than that of soft tissue (1540 m/s). Speed errors appear as a step-off, as if structures are “split” or “cut.” AKA range error artifact. Violation of assumption 3.
Definition
Speed error
Term
Appears when sound energy is transmitted in a direction other than along the beam’s main axis. The artifact and the true reflector are located side by side at the same depth. Lobe artifact degrades lateral resolution. Violation of assumption 2.
Definition
Lobes
Term
Created when a sound pulse changes direction during transmission. When a sound wave strikes a boundary obliquely and the media on either side of the boundary have different propagation speeds. Refraction artifact degrades lateral resolution. A copy is side-by-side, or the same depth as the true reflector. Violation of assumption 1.
Definition
Refraction
Term
The beam flares out like a bell of a trumpet; therefore, reflections from structures above or below the assumed imaging plane may appear in the image. AKA section thickness artifact or partial volume artifact. The true reflector lies either above or below the assumed imaging plane but is displayed within the image. Violation of assumption 5.
Definition
Slice thickness
Term
  • Occurs when a pair of side-by-side reflectors are closer than the wide of the sound beam. These reflectors are positioned perpendicular to the beam. Two objects appear as one. 

Definition
Lateral resolution artifact
Term
Created when a long pulse strikes two closely spaced structures, where on is in front of the other. The structures are parallel to the beam’s main axis. Only one reflection will appear on the image if the structures are closer together than one-half the spatial pulse length.
Definition
Axial resolution artifact
Term
Created when sound pulses glance off a second structure on the way to or from the primary reflector. As a result, the transmit path length differs from the return path length. Violation of assumption 2.
Definition
Multipath
Term
When a sound beam strikes a curved or oblique reflector, some of the reflected sound may be directed away from the transducer. The amplitude of the reflection received by the transducer may be less than expected. 
Definition
Curved and oblique reflectors
Term
Related to overall detail in an image. It is determined by multiple factors, including line density (closely packed sound pulses), axial resolution, and lateral resolution. With high line density, the image exhibits great detail, and the spatial resolution is exceptional. With a low lindensity (wider gaps between the sound pulses) the image exhibits less detail, and the spatial resolution is poor.
Definition
Spatial resolution
Term
Occurs when a reflecting structure is located deeper than the imaging depth of the image. This reflector is placed at the shallow location on the image. Range ambiguity artifact is eliminated by increasing the PRP. Longer PRP means deeper imaging and decreased PRF.
Definition
Range ambiguity
Term

Appears as small amplitude echoes and results from many sources, including electrical interference, signal processing, and spurious reflections. Noise is more likely to affect low-level hypoechoic regions rather than bright echogenic areas.

Definition
Noise
Term
Noise resulting from the constructive and destructive interference of small sound wavelets.
Definition
Speckle
Term
Another form of noise, is the presence of false echo signals arising from locations outside the main sound beam. Side lobes, grating lobes, and section thickness artifact are sources of clutter.
Definition
Clutter
Term
Reduces an image’s noise content. The goal of harmonic imaging is to selectively distinguish meaningful reflections from noise, thereby increasing the signal-to-noise ratio.
Definition
Harmonic imaging
Term
Four requirements for a QA program are:
Definition
  1. Assessment of system components 

  2. Reparirs 

  • Preventive maintenance 

  • Record keeping 

Term
The five goals of a QA program are:
Definition
  • Guarantee proper operation of the system

  •  

  • Detect gradual changes 

  • Minimize downtime 

  • Reduce the number of non-diagnostic exams 

  • Reduce the number of repeat scans 

Term
What are the methods used for QA?
Definition

Test under known, defined conditions

 

Constant instrument settings

 

Use phantom with measurable characteristics

 

Image in identical environment

Term
  • Have ultrasonic features similar to soft tissue, such as, speed of sound, attenuation, scattering characteristic, and echogenicity. 

  • Gray scale is evaluated with this phantom since it contains small scatterers that act like soft tissue. Structures that mimic hollow cysts and solid masses are also embedded in the phantom.

Definition
Tissue equivalent phantom 
Term
  • Flow phantoms are the devices of choice for evaluating Doppler systems. Modern Doppler phantoms include a circulation pump which propels fluid through vessels embedded in a tissue equivalent phantom. Other Doppler phantoms contain vibrating strings or moving belts. 

  • Doppler phantoms assess the characteristics of all Doppler modalities, including pulsed, continuous wave, color, and power mode. 

Definition
Doppler phantom 
Term
  • Another special phantom assesses the slice thickness and its effect upon image accuracy. Slice thickness determines elevational resolution.

  •  

  • Water-filled phantom. 

  • Pins set throughout the phantom to measure: 

  • Dead Zone 

  • Focal Zone 

  • Longitudinal resolution 

  • Lateral resolution 

  • Horizontal registration 

  • Vertical registration 

  • Registration accuracy 

Definition
Beam profile/slice thickness phantom 
Term
What is minimum sensitivity?
Definition
With the TGC set flat, increasing the gain from its minimum value to the pint when an echo is displayed on the CRT determines the minimum sensitivity.
Term
What is normal sensitivity?
Definition
The gain setting where all of the pins in the AIUM test object are displayed on the CRT. Normal sensitivity is found at a higher gain than the minimum sensitivity. All other performance measurements are made at this setting.
Term
What is sensitivity?
Definition
When adjustments make changes in display or echo brightness from scarcely visible to fully saturated, sensitivity is being assessed.
Term
What is dead zone?
Definition
It is the distance close to the transducer that cannot produce an accurate image on the display.
Term
What is range accuracy?
Definition
The machine's ability to display echoes in the proper depth.
Term
What is registration accuracy?
Definition
The machine's ability to place echoes in proper positions while imaging from different orientations.
Term
What is horizontal calibration?
Definition
The machine's ability to position echoes in their correct position along a distance perpendicular to the US beam.
Term
What is focal zone?
Definition
The depth at which the intensity is the highest and the beam is the narrowest.
Term
What is longitudinal resolution?
Definition
The smallest distance at which two pins are displayed as two separate echoes, front to back or parallel to the sound beam.
Term
What is lateral resolution?
Definition
The minimum distance that two rods are displayed as two separate images can be determined. Perpendicular to the sound beam.
Term
What is the Gold Standard?
Definition
A "perfect" technique, for example MRI or angiography, that we deem 100% accurate to which our ultrasound results are compared.
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